9-year-old Tully James was born without a left forearm and hand. He says he can do "anything." Photo credit: Jasmin Singh
9-year-old Tully James was born without a left forearm and hand. He says he can do "anything." Photo credit: Jasmin Singh

Health care in North Carolina was often the big story in 2013, with the debate over Medicaid at the top of the list. But some of our most popular stories of 2014 were small stories that our reporters discovered and readers found interesting, intriguing and significant.

This is North Carolina Health News’ list of the Top 10 (actually, 11) health stories of 2014, based on the web traffic these stories received over the year.
Disagree with our list? Think we missed something? Let us know!!
1. North Carolina’s Medicaid program will change, we just don’t know what it will look like yet
Members of the Medicaid Reform Advisory Group listen to speakers during the meeting Wednesday. L to R: Sen. Louis Pate, Richard Gilbert, MD, Dennis Barry (chair), Peggy Terhune, PhD, Rep. Nelson Dollar. Photo credit: Rose Hoban
Members of the Medicaid Reform Advisory Group listen to speakers during a meeting in February. L to R: Sen. Louis Pate, Richard Gilbert, Dennis Barry (chair), Peggy Terhune and Rep. Nelson Dollar. Photo credit: Rose Hoban

Medicaid was one of the most varied and “interesting” stories of the year. First came the Medicaid Reform Advisory Group, which recommended changing North Carolina’s Medicaid program to a system that incentivized providers to create accountable care organizations to deliver services to the state’s almost 1.8 million Medicaid recipients.

But members of the state Senate didn’t like the plan, and the future of Medicaid become one of the most contentious issues dividing the House and the Senate throughout the “short” legislative session. Finally, the legislature adjourned without resolving the Medicaid question and convened another committee process this past fall to examine options for the program’s future. That process recently ended with yet another contentious debate over the shape of the program and a vote that revealed a rift between House and Senate members.

All the while, activists, academics and members of the legislative Democratic caucus maintain that expanding Medicaid, as provided for under the Affordable Care Act, is the right move. They’re finding some succor in statements made recently by Gov. Pat McCrory and Department of Health and Human Services Sec. Aldona Wos.

Medicaid will likely continue to be a divisive issue during the upcoming “long” legislative session that begins Jan. 14.

Pam Scheffer-Bossardet (back to camera) helped organize the Morrisville meeting and moderated questions from the audience of about 150 people over the course of three hours.
Pam Scheffer-Bossardet (back to camera) helped organize the Vietnam Veterans of America Morrisville meeting and moderated questions from the audience of about 150 people over the course of three hours. Photo credit: Rose Hoban
2. Vietnam Vets still looking for answers on Agent Orange

Vietnam veterans are still seeking answers from the Department of Veterans Affairs over the long-term effects of the defoliant Agent Orange. The VA admits that dioxins in Agent Orange cause a plethora of health effects, and former soldiers exposed to the chemical have higher rates of some cancers, leukemias, lymphoma, Parkinson’s disease and diabetes. Now evidence points to the presence of genetic diseases in the children of these exposed soldiers, but there are still many questions.

The Vietnam Veterans of America has been sponsoring public meetings around the country, including the first North Carolina meeting, held in Mooresville in February. Subsequent meetings have taken place in Wilmington and Asheville.

3. NC elementary students get paddled, mostly in one county

Only a few school districts in North Carolina continue to allow corporal punishment for students who act out. One district, in Robeson County, accounts for the vast majority of the state’s incidences of paddling, a story that got a lot of attention from readers.

4. What’s in this year’s Health and Human Services Budget?

For the third year running, we compiled tables on the North Carolina budget comparing what the House wanted, what the Senate wanted and what was finally passed by the entire legislature. It’s a feature that readers appreciate: We know that from the numbers of page views and the amount of time readers spend poring over the details.

What will coverage on the individual market cost you? Get an estimate on our interactive map.
Our interactive map showed readers what they could expect to spend on the health insurance exchanges.
5. North Carolina *hearts* Obamacare

After a rocky start, the health insurance exchanges created under the Affordable Care Act (Obamacare) finally got rolling in North Carolina in a big way, and surpassed the expectations of many.

Readers also spent a lot of time on our interactive map of Obamacare premium rates.

6. Carcinogens lace municipal water near coal plants, coal ash ponds

One afternoon, our environmental health reporter, Gabe Rivin, was digging around on the website of the Environmental Protection Agency when he noticed consistently high levels of trihalomethanes, a family of carcinogenic chemicals, in water near coal ash ponds. After digging deeper, Gabe found that trihalomethanes have been fouling municipal water systems near the ash ponds for years. There’s little regulation of the precursor chemicals that create trihalomethanes in municipal water treatment systems. Gabe also found that hydraulic fracturing (fracking) could create the conditions for formation of these same carcinogens in municipal water systems downstream of fracking sites.

Leslie Sharpe, stands in the laboratory space of the Sylvan Health Center where blood samples and the like are stored.
Leslie Sharpe stands in the laboratory space of the Sylvan Health Center, where blood samples and supplies are stored. Photo credit: Hyun Namkoong
7. Nurse practitioners step in to provide rural health care

As the debate over the future of Medicaid plays out in Raleigh, conditions on the ground are shifting and moving ahead. In Alamance County, much of the care for rural patients – both those with Medicaid and people who lack any health insurance – is being provided by a nurse practitioner who runs a clinic out of a trailer on the grounds of an elementary school.

Look for more reporting on rural health issues in the coming year, courtesy of a grant we received from the Winston-Salem Foundation.

8. BPA can play a role in breast cancer cell formation

Scientists at Duke University and at the National Institute of Environmental Health Sciences, based in North Carolina, have been active in research around bisphenol A, otherwise known as BPA, a chemical used to make plastics and epoxy resins.

In June, Duke researchers shared new evidence that BPA not only accelerates cell growth in inflammatory breast cancer but also makes disease treatment less effective.

Skyler Thompson hands Marlo Duncan a baked potato. Duncan had hers add cheese and onions.
Skyler Thompson hands Marlo Duncan a baked potato at the NC State Fair in October. Photo credit: Rose Hoban
9. Looking beyond deep-fried at the NC State Fair

Once again, editor Rose Hoban went looking for healthy food offerings at the annual state fair, and actually managed to find some delicious and fun offerings that won’t make your cardiologist hang his or her head and weep.

10. Ebola-tracking software created in North Carolina

As the world watched in horror as the Ebola virus ravaged populations in West Africa, students from UNC created software to track the virus’ spread through Liberia.

The website is used by government officials in that country to track the disease on a daily basis.

Karyn Traphagen, Tully James and his mom Karen celebrate Tully's new hand.
Karyn Traphagen, Tully James and his mom, Karen, celebrate Tully’s new hand. Photo credit: Jasmin Singh
BONUS: DIY prosthetic hands printed locally help kids with disabilities

Geeks are getting more love these days for being creative, inventive and prolific makers of cool stuff. Now 3D printing technology is allowing local inventors to construct prosthetic devices for people with physical disabilities.

This story was written, photographed and filmed by our wonderful summer intern, Jasmin Singh, who kept bugging her editors to try more “alternative” story forms.

This was our attempt to look a little more like Buzzfeed. See what you think.

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